龚兴荣,何奔,乔志卿,张清,葛恒,何清,韩志华,厉锦华

• 1:上海交通大学医学院附属仁济医院心内科
• 2:上海交通大学医学院附属仁济医院心内科

摘要(Abstract)：

目的探讨急性ST段抬高型心肌梗死(STEMI)急诊PCI术前血清醛固酮(aldosterone,ALDO)水平和术后无复流的关系。方法2007年1月至2007年10月连续收集117例STEMI患者,在发病12h内行急诊PCI,在术前股动脉穿刺后留取血清,采用放射免疫法测定醛固酮含量。按ALDO水平分成三组,ALDO<100pg/mL组37例,100pg/mL≤ALDO≤200pg/mL组43例,ALDO>200pg/mL组37例。PCI术后通过评估冠状动脉血流TIMI分级,来判断无复流的发生。又将117例分为无复流(10例)和心肌充分复流(107例)两组,比较两组ALDO水平。结果ALDO>200pg/mL组的无复流发生率(21.62%)明显高于ALDO<100pg/mL组(2.70%)和100pg/mL≤ALDO≤200pg/mL组(2.33%),P=0.0038。另外,无复流组ALDO水平为379.1±234.3pg/mL,明显高于心肌充分复流组的164.5±100.6pg/mL(P=0.0010)。STEMI发病早期PCI术前的ALDO水平与术后TIMI分级两者呈负相关(相关系数-0.39241,P<0.0001)。结论随着血清醛固酮水平的升高,无复流的发生也相应增加。STEMI发病早期PCI术前的ALDO水平与术后TIMI分级两者呈负相关。

关键词(KeyWords)： 心肌梗死;醛固酮;心肌再灌注

Abstract:

Keywords:

基金项目(Foundation): 上海市科委登高重点课题(064119501);; 浦东新区重大协作课题(PW2006D-3)

作者(Author): 龚兴荣,何奔,乔志卿,张清,葛恒,何清,韩志华,厉锦华

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